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Home My WebLink About2010-00790 - roofing r CITY OF OKONO PERMIT NO.: 2010-00790 2750 KELLEY PARKWAY ORONO, MN SS35G- DATE ISSUED: 09/OU2010 952 249-4600 FAX: 952 249-4616 ADDRESS : 4745 CREEKWOOD TR PIN : 30-118-23-33-0008 LEGAL DESC : PAINTERS WOODS : LOT 006 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -ASPHALT ACTIVITY : O/S BUILDING - UNDEF[NED VALUATION : $ 11,835.49 NOTE: TEAR OFP REROOF-ASPHAL'I�SINGLGS APPLICANT PERMIT FEE SCHEDULE 221.25 FIRST CHOICE BUILDERS STATE SURCHARGE(VALUATION) 5.92 12245 NICOLLET AVE S BURNSVILLE, MN 55337- TOTAL 227.17 (952)808-7400 Minnesota State License#: 20317975 OWNER YOCKEY, STEVEN&CLOLLEEN 4745 CREEKWOOD TR MAPLE PLAIN, MN 55359 AGREEMEI�IT AND SWORN STATEMENT "I'he work for which this permit is issued shall be performed according to the approved plans and specifica[ions,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant pennission for additional or related work which requires separate pennits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified hereia This permit will cxpire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of I 80 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested i conformance with the State Building Code.This permit may be revoked any time Ibr due cause. � � / ;_ � / � / � �� ) / G�'�./ � �< � �Q pp ' nt Permi Signature Date Is d By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: (�� - (7� g,�,� PO Box 66 �,,` � Crystal Bay, MN 55323-0066 Date received: � D j a ��a �''� `��a� � Street Address: Received by: "� � °B„*� �n G� 2750 Kelley Parkway Plan review f : t�kESH�4� Orono, MN 55356 � Total Fee: � �� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: L S -�C, �„�U� ��) Will this be a Parade of Homes, Remo lers Showcase Home or other Display Home? ❑ Yes No If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be required unless applicant demonstrafes sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/A IC T IN . RMATIO�• � � Name: � f�'L,� State License# � Expiration Date: ' � Phone: — vU ice cell Mailing Address: ' d � c��a � ;,, �,1 ,�.� ZIP: " Contact Person: - r Applicant is: o ractor / omeowner (Circle One) Email and/or Fax: PROPERTY OWN INFORMATION• Name: ' � �I �eti "v� Phone (day): — Address: � ✓< � (��b 6�'� � Cit : c c,�.� ZIP: Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel MCWD review&permits ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Sidin Deephaven, MN 55391 g ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Re-roof ❑ Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ � "� �� APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete; • Some or all of the information that you are asked to provide on this application is classified by State law as either private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this nformation is to annually update our records and records of other governmental agencies re uired b taw. If ou refuse to I the information, the a lication ma not be issued. ApplicanYs Signature: � '` � Date: 7� �v/U LastUpdated: OS-04-2009